Colon Prep Using Clenpiq

COLONOSCOPY

ATTENTION!!! PLEASE READ IMMEDIATELY!!!

** If you take Blood Thinners or Anticoagulants (Heparin, Coumadin, Plavix) it is important thatyou notify your doctor who prescribed these medications to discuss stopping those drugs ONEWEEK prior to your procedure.

** If you take any ASPIRIN product, such as Aspirin, Ecotrin, Motrin, Advil, Aleve, etc, you mustdiscontinue their use one week prior to the procedure as well.

** If on any of those medications, please contact the prescribing doctor to discuss stopping thosemedications for one week. If you have contacted your doctor and he/she advised you NOT towithhold the medications, please contact our office IMMEDIATELY.

** If you need medication for pain relief, you may take acetaminophen, (Tylenol regularorextrastrengthonly!)

** FIVE days before the procedure avoid ANY FOOD CONTAININGSEEDS. Examples are corn, grapes tomatoes,watermelon, rye bread, poppy or sesame seeds.

** If you are a diabetic see attached sheet.

** Please continue to take ALL OTHER medications as prescribed to you as you normally would EVENTHE MORNING OF THE PROCEDURE. You may need to reschedule your pills the night before the procedure to AVOID TAKING MEDICATION WHILE DRINKING THE PREP.

** Please notify our office immediately if you require ANTIBIOTICS before this procedure isperformed.

** It is important to fill out the medication sheet in this packet, and list ALL medications on the sheet.The list should include name of drug, dose and how many times a day you take it. Bring this sheetto the hospital.

** You MUST have a driver with you to bring you home after the procedure. A taxi is only acceptableif you have another adult, besides the taxi driver, with you.

YOUR PROCEDURE IS SCHEDULE FOR:

DATE:

PLACE: Millard Fillmore Suburban Hospital1540 Maple Rd, Williamsville, NY 14221

REPORT TO ADMISSION:

Colonoscopy prep for the day before procedure

You may have a normal breakfast and then start full liquid diet.

Drink the first cup at 10:00AM

After the first dose drink 2 8oz cups of clear liquid every hour until the next dose. (Seeclear liquid diet list)

Second bottle drink at 4:00pm

After the second dose drink 2 8oz cups of clear liquid every hour until the next dose. (See clear liquid diet list)

At 6pm Take 2 tablets of Dulcolax

Please finish all the solution before midnight, if you finish before midnight, you may have clear liquids until that time.

MIDNIGHT DO NOT EAT OR DRINK ANYTHING UNTIL AFTER THE PROCEDURE.

Clear Liquid Diet

DO NOT EAT OR DRINK ANYTHING RED OR PURPLE

Do NOT drink any alcoholic beverages

ALLOWED LIQUIDS:

BEVERAGES:

•Water, tea or coffee (NO milk or nondairy creamer)

•Sweeteners are ok in the coffee

•Soft drinks (7UP, cola, ginger ale, orange, Sprite, ect.)

  • Gatorade, Kool aide, Lemonade- with no pulp

•Strained fruit juices without pulp (apple, white grape, orange, white cranberry, etc.)

SOUPS:

• Low sodium chicken or beef bouillon/broth

MISCELLANEOUS:

• Hard candies

•Jell-O(lemon, lime or orange);no fruit or toppings

• Popsicles or Italian ice

INSTRUCTIONS FOR DIABETIC PATIENTS PRIOR TO COLONOSCOPY

CLEAR LIQUID DIET MAY INCLUDE BEVERAGES WITH SUGAR

YOU WILL NOT BE TAKING YOUR DIABETIC MEDICATION (NO INSULIN, METFORMEN AND/OR ANYOTHER DIABETIC MEDS. YOU WILL NOT BE EATING SO YOU DON'T WANT TO LOWER YOURSUGAR LEVEL.

THE DAY OF YOUR PROCEDURE TAKE DIABETIC MEDICATIONS WITH YOU TO THE HOSPITAL SOYOU CAN TAKE THEM AFTER THE PROCEDURE.

ADVISE THE NURSES AT THE HOSPITAL SO THEY CAN ORDER A TRAY FOR YOU OR, IF YOU AREGOING TO EAT WHEN YOU GET HOME, TAKE YOUR DIABETIC MEDS AT THAT TIME.

CONSULT WITH YOUR ENDOCRINOLOGIST TO MAKE SURE THERE IS NOTHING THEY WOULDWANT TO DO DIFFERENTLY.